Category Archives: News

The Biology of ACL Healing: The Wild Card of Recovery

Ligamentization – The Wild Card

One of the most critical steps in ACL reconstruction is grafting a tendon into the knee to replace the damaged ACL. Following surgery, the graft not only has to heal tightly in its new position but also transition structurally from a functioning tendon to a functioning ligament—a process known as ligamentization. Believe it or not, this process takes time! Microscopic studies, in which physicians have taken small samples of healing ligaments following ACL reconstruction to determine their rate of ligamentization, suggest that this process can take anywhere from 6 to 24 months.

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When is an athlete ready for contact sports after ACL surgery?

Returning to Sport Following ACL Reconstruction

After ACL reconstruction, the most common question is also the most difficult to answer: “When will I be ready to go back to ___?” In short, there is no blanket answer; there are many factors that determine when the time is right for a patient to return to sport. These factors are physical, biologic and psychological in nature and they affect each patient’s recovery in a unique way. At the end of the day, return to sport is a decision that needs to be made on a patient-to-patient basis, weighing the benefits of continued rest and rehabilitation with the risks and benefits of returning to sport.

Continue reading When is an athlete ready for contact sports after ACL surgery?

Biceps Anatomy Study

Thank you to Eric Branch for his help with our recent study on the biceps femoris. It was published last month in the Orthopaedic Journal of Sports Medicine. This tendon injury can accompany anterior cruciate ligament injuries in football players. The more we learn about it the better we will be at our repairs/reconstructions. In this study we learned exactly where the tendon inserts on the tibia and fibula and its association with the anterolateral ligament.

Meniscus Repair Paper Published in The American Journal of Sports Medicine

Last month a biomechanical study which we completed at the Andrews Research and Education Foundation was published in the American Journal of Sports Medicine.


The study evaluated the repair strengths of four meniscus repair methods for radial meniscus tears. Radial meniscus tears can accompany anterior cruciate ligament (ACL) tears, particularly radial tears of the lateral meniscus. A new instrument known as the Ceterix Novostitch was evaluated.

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Figure 1

The study determined that complex patterns of suture repair are stronger than simple patterns.

11th Annual Middle East Orthopaedics Conference

Dr. Anz was an invited faculty member of the 11th Annual Middle East Orthopaedics Conference in Dubai, UAE.  Chaired by Dr. William Murrell, this meeting involved faculty from all over the world including Dr Charles Brown from Abu Dhabi , Prof Brian Cole from the Rush Medical Center, Prof Mandeep Dhillon from Chandigarh, India, Dr Elizaveta Kon and Prof Maurilio Marcacci from Bologna Italy, Prof Nicola Maffulli from The Royal London Hospital, Prof Parag Sanchetti from Maharashtra, India,  Prof Ullrich Schneider from Rottach-Ergen, Germany, and Dr Clarence Shields of the Kerlen-Jobe Clinic.  

panel 2Dr. Anz gave a lecture on Peripheral Blood Stem Cells for Cartilage Regeneration as well as led a roundtable discussion session entitled: Primetime for cartilage and biologics transition to a new paradigm.Roundtable discussion: Primetime for cartilage and biologics transition to a new paradigm.

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AAOS Now Interview

Dr. Anz was interviewed regarding his JAAOS article examining the application of biologics for the rotator cuff, meniscus, and cartilage by AAOS Now, the official member newsmagazine of the American Academy of Orthopaedic Surgeons.


Maureen Leahy asks:

Biologics have been used for some time in medicine. What is their role in orthopaedics?

Dr. Anz:

In my opinion, biologics represent the next frontier in orthopaedics.  During the past 30 years, particularly in sports medicine, the focus has been on the use of the arthroscope, which revolutionized how we performed treatments.  I believe biologics will revolutionize the next 30 years.  

Maureen Leahy: 

Are each of these biologic technologies equally important?

Dr. Anz:

I don’t think any one of them is more important or warrants more study than the others.  PRP, BMA, and stem cells are like arrows in a quiver.  In some instances, PRP will be the right arrow to use; in a different situation, BMA might be more appropriate.  From a regulatory standpoint, PRP and BMA are the arrows we can use right now.  The FDA has made it clear that it is going to take a tough stance on stem cells, no matter what the harvest site-and rightfully so. It will be exciting, however, once we can use them. 

If you would like to see the interview in its entirety, go to:

Biologics in Rotator Cuff, Meniscus, Cartilage and Osteoarthritis Article

Drs. Anz, Hackel, Nilssen, and Andrews authored an article regarding the application of biologics in sports medicine which was published this month in the Journal of the American Academy of Orthopaedic Surgery.  The article entitled “Application of biologics in the treatment of the rotator cuff, meniscus, cartilage, and osteoarthritis” reviewed the current status of the use of platelet rich plasma, bone marrow aspirate, and stem cells within sports medicine.

what-can-stem-cells-doThere is evidence that these technologies are going to influence the way that orthopaedic surgeons practice medicine, and work at the Andrews Institute is focusing on leading the way but also producing proof that these methods are making a difference in the lives of our patients.


If you have questions about platelet rich plasma, bone marrow aspirate, or stem cells please contact the Gulf Breeze, Florida orthopedic surgeon, Dr. Adam Anz located at the Andrews Institute.

Figure 11-Chondrogenesis Theory.112

Hip and Biologic Lectures at the10th Middle East Orthopaedics Conference

4-1 Arthroscopy JournalAdam Anz, MD was invited to speak at the 10th Annual Middle East Orthopaedic Conference in Dubai, United Arab Emirates.  This seminar is part of the larger Arab Health Conference which includes 19 specialties with international speakers and attendees from all corners of the globe.  Dr. Anz presented on Hip Arthroscopy for Femeroacetabular  Impingement and Biologics to Augment the Hip Arthroscopy Practice. Both lectures sparked interest and debate as these new topics are gathering speed throughout the world. Doctors  everywhere are interested in the use of a patient’s own stem cells to improve quality of care and outcomes.